Fraud convictions would permanently bar health providers from Medicare and Medicaid

What does this do?

HR 8865 would permanently ban health care providers convicted of fraud, theft, embezzlement, or similar financial crimes from participating in Medicare, Medicaid, and other federal health programs for convictions occurring after the law takes effect. Current law allows a set exclusion period after which providers may seek reinstatement. This bill eliminates that reinstatement option entirely for the covered categories of convictions.

Who does it affect?

Health care providers — including doctors, nurses, clinics, and medical equipment suppliers — convicted of qualifying fraud-related crimes are directly affected. Patients who rely on Medicare or Medicaid are also affected, as their providers would be permanently removed from those programs upon conviction.

Why does it matter?

Permanently excluding convicted providers removes an existing pathway for return to federally funded health programs, regardless of time served or other circumstances. Federal health care fraud costs the government billions of dollars each year, and the bill is stated to target protection of taxpayers.

Where does it stand?